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Lymphoreticular and haematopoetic > Abnormalities of the Erythron > Flashcards

Abnormalities of the Erythron Flashcards

1
Q

What do RBCs look like?

A

Biconcave disc shape in most species giving an area of central-pallor and a high surface area to volume ratio and allows for deformability

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2
Q

What shape RBCs do camelids have?

A

Elliptical RBCs

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3
Q

How do bird and reptile’s RBCs differ?

A

They are nucleated

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4
Q

What do RBCs contain?

A

Haemoglobin as their function is oxygen transport

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5
Q

What are the production sites of RBCs?

A

Liver/spleen in the foetus and then swaps to bone marrow in neonates
In growing mammals bone marrow of all bones produces RBCs in adults only femur/humerus and flat bones do

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6
Q

Which organs become activated in increased demand for RBCs?

A

Liver, spleen and long bone bone marrow

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7
Q

What are the production requirement for RBCs?

A

Stem cells, space in marrow, growth factors (IL-3, GM-CSF, G-CSF erythropoietin), iron, cholesterol/lipids for membrane, enzyme pathways for construction and maintenance

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8
Q

How do RBCs mature?

A

Series of cells types starting with lots of cytoplasm and a large nucleus which gradually condenses and finally disappears

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9
Q

What is the lifespan of RBCs?

A

100 days in dogs, 70 days in cats and 150 days in cattle and horses

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10
Q

How are RBCs removed from the circulation?

A

Phagocytic macrophages taking up senescent red cells and recycling components or intravascular haemolysis

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11
Q

What is the definition of anaemia?

A

Reduction in red cell mass evidenced by a decreased haemoglobin concentration, packed cell volume, haematocrit or red blood cell concentration

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12
Q

What is a haematocrit?

A

Gives same information as PCV but is calculated by a machine so relies on red cell count and volume and is less accurate

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13
Q

What is the red blood cell concentration (RBC)?

A

Total number of red blood cells

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14
Q

What is the haemoglobin (Hgb)?

A

Total oxygen carrying capacity

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15
Q

What is the PCV?

A

Percentage of red cells in a volume of blood through a manual technique that also allows buffy coat assessment, plasma and total protein measurement

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16
Q

What causes a decreased red cell mass?

A

Increased loss too large or fast for compensation

Decreased production with losses not matched by production

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17
Q

What are the different ways of classifying anaemia?

A

By severity, by haemoglobin concentration, by red cell measurements or regenerative/non-regenerative

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18
Q

What are the characteristics of mild anaemia?

A

From just below normal PCV to 10% below normal PCV, may not affect animal until exercised, common in animals with long standing disease/endocrine disorders

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19
Q

What are the characteristics of moderate anaemia?

A

Varies between species depending on normal PCV for each, animals may show weakness or be well adapted but only if chronic, mucous membrane pallor and fast bounding pulse

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20
Q

What are the characteristics of severe anaemia?

A

PCV in lower teens downwards, pale, weak, unable to exercise, may need oxygen before diagnostic procedures, don’t fight with very anaemic cats

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21
Q

How is anaemia classified by haemoglobin concentration?

A

Either normochromic or hypochromic can’t be hyper
MCHC/MCH measured on panel
Due to decreased iron/poor iron incorporation

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22
Q

How are red cell measurements classified?

A

Normocytic, microcytic or macrocytic

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23
Q

What are the characteristics of normocytic anaemia?

A

Erythrocytes of unremarkable size often associated with mild non-regenerative anaemia or acute haemorrhage

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24
Q

What causes microcytic anaemia?

A

Red cell haemoglobin concentration determines when division stops so iron deficiency allows one more division resulting in a smaller cell with same haemoglobin concentration as a normal cell
PSS/iron deficiency/hepatic failure or Akitas

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25
Q

What causes macrocytic anaemia?

A

In regeneration seen as polychromatophils
Some poodles have them
Generally young cells
FeLV cats/myelodysplasia/artefact of stored blood

26
Q

How does regenerative anaemia occur?

A

Fall in oxygenation detected by kidneys which release erythropoietin which activates the bone arrow and takes 2-3 days for cells to appear in circulation

27
Q

What is the indicator of regenerative anaemia?

A

Reticulocytes

28
Q

How are reticulocytes detected?

A

Diff-Quick or Giemsa stain look larger, bluer cells called polychromatophils
New Methylene Blue precipitates RNA forming aggregates/reticulum = reticulocytes

29
Q

How do reticulocytes differ in cats?

A

Retics released as aggregate retics and mature to punctate retics over time
Counts should record either aggregate or both

30
Q

What is the reticulocyte percentage?

A

Number of retics per 1000 cells counted as a percentage

31
Q

What is the corrected reticulocyte?

A

Retic% x patient PCV/normal PCV

Takes anaemia into account

32
Q

What is the absolute reticulocyte concentration?

A

RBC concentration x retic%

33
Q

What are the possible routes of external haemorrhage?

A

Melena, urinary tract, epistaxis, post trauma/surgery

34
Q

What are the possible routes of internal haemorrhage?

A

Bleeding tumours, trauma, into tissue (bleeding diathesis), surgery

35
Q

What are the different causes of haemolysis?

A

Immune-mediated, parasites, Heinz-body associated anaemia, eccentrocytes, sheer injury and inherited diseases

36
Q

What are the signs of immune-mediated haemoytic anaemia (IMHA)?

A

Anti-red cell antibodies, may agglutinate, Coombs test positive, can be severe/rapid, usually strongly regenerative, ghost cells intravascularly, spherocytes extravascularly, increased bilirubin/neutrophilia/monosytosis/platelets affected

37
Q

What parasites cause regenerative anaemia?

A

Mycoplasma haemofelis and M haemomimutum or Babesia

38
Q

What are the signs of babesiosis?

A

Epicellular parasite with large and small forms, increased fragility and haemolysis, cycles on 3-8 week basis, diagnosis by PCR

39
Q

What are Heinz bodies and what causes them?

A

Denatured haemoglobin due to oxidative injury from paracetamol, onions, Vit K, propylene glycol

40
Q

What are eccentrocytes?

A

Uneven haemoglobin distribution within cell due to oxidative damage to membrane seen most often in dogs/horses with red maple toxicosis

41
Q

What are the different inherited causes of regenerative anaemia?

A

Pyruvate kinase deficiency in Basenhis and Basset Hounds
Phosphofructokinase deficiency in English Springers
Feline porphyria

42
Q

What are the general causes of non-regenerative anaemia?

A

Inflammatory/chronic disease, renal, endocrine, FeLV, non-regenerative marrow, myelopthisis, myelofibrosis

43
Q

What are the characteristics of non-regenerative anaemia due to inflammatory/chronic disease?

A

Normocytic or normochromic usually mild and slowly progressing due to Fe sequestration, inflammatory mediators and shortened erythrocyte survival

44
Q

What is the pathogenesis of renal non-regenerative anaemia?

A

Kidneys produce erythropoietin and in chronic renal failure production decreases

45
Q

What are the characteristics of renal non-regenerative anaemia?

A

Normocytic, normochromic and mild to moderate

46
Q

What is the treatment option for renal non-regenerative anaemia?

A

Can give injection of erythropoietin but can develop antibodies against it

47
Q

What endocrine diseases can cause a non-regenerative anaemia?

A

Hypothyroidism and hypoadrenocorticism

48
Q

What is the pathogenesis of endocrine non-regenerative anaemia?

A

Thyroid hormone and cortisol have facultative effect on red cell prodcution

49
Q

What are the characteristics of endocrine non-regenerative anaemia?

A

Normocytic, normochromic, mild anaemia

50
Q

What is the pathogenesis of FeLV non-regenerative anaemia?

A

Selective depression of erythropoiesis, dysplastic production and myeloproliferative disease crowding out
Usually non-specific erythroid hypoplasia

51
Q

What are the characteristics of FeLV non-regenerative anaemia?

A

Normocytic/macrocytic and normochromic

52
Q

What is the pathogenesis of aplastic anaemia?

A

All precursor cells wiped out with only fat, plasma cells and mast cells left and need biopsy to diagnose

53
Q

What can cause aplastic anaemia?

A

FeLV, oestrogen toxicity, phenylbutazone, chemotherapy and other unknown causes

54
Q

What is myelophthisis?

A

Neoplasia crowding out the bone marrow resulting in an altered environment

55
Q

What causes myelofibrosis?

A

Often a response to injury of fibrous elements of marrow and may be reactive following prolonged regenerative attempts

56
Q

How is myelofibrosis diagnosed?

A

Core biopsy with reticulin staining of fibrous elements

57
Q

What is erythrocytosis?

A

Increased HRT, RBC count and haemoglobin

58
Q

What causes erythrocytosis?

A

Spurious or relative due to dehydration or RBC distribution

59
Q

What is primary erythrocytosis?

A

Myeloproliferative disorder or erythoid stem cells, EPO levels normal or deceased with normal PO2

60
Q

What causes secondary erythrocytosis?

A

Chronic hypoxia, EPO secreting tumours and EPO levels elevated

Lymphoreticular and haematopoetic (12 decks)

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